Protective garment for bedridden people

ABSTRACT

A garment for protecting an elbow or other protuberance of a bedridden patient includes sleeve for encompassing such protuberance. The sleeve is made from a cloth having a relatively low coefficient of friction with respect to sheets and other bedclothes and employing a nonabsorbent monofilament fiber such as nylon. The sleeve has a stretchability at least in direction transverse of the axis of the sleeve. A nonslip cushion constituted as a sheet of foam rubber is adhered to the interior of the sleeve to provide a protuberance-covering pressure-bearing portion constituted as a laminate of foam rubber sheeting directly in contact with the flesh and covered by the cloth layer, this portion being devoid of any seams or other obstructions which can cause localized pressure on the flesh at the pressure-bearing portions of the protuberance. A casing in the end of each sleeve completely covers an elastic cord. Together they tend to prevent the sleeve from rolling up and they act to stabilize the garment to maintain the cushion in contact with the pressure bearing portion of the flesh adjacent the protected protuberance.

United States Patent Pankers [54] PROTECTIVE GARMENT FOR BEDRIDDENPEOPLE [72] Inventor: Alva L. Pankers, Bloomington, Minn.

[73] Assignee: William A. Braddock, Minneapolis, Minn.

[22] Filed: July 6, 1970 [21] App1.No.: 52,570

[52] US. Cl ..2/l6, 128/149, 128/165, 2/22 [51] Int. Cl. ..'..A4ld 13/08[58] Field of Search ..2/16, 22, 24, 240; 128/165, 128/166, 149, 153

[561 References Cited UNlTED STATES PATENTS 3,322,118 5/1967 Sotherlin..2/16 X 2,130,552 9/1938 Kuhn ..2/240 1,081,245 12/1913 McCall ..2/242,140,598 12/1938 Rhorer ..2/24 X 2,431,287 1 H1967 Washington 2/24 UX2,552,177 5/1951 Hurt ..2/24 3,458,867 8/1969 Moore et al. ....2/163,508,544 4/1970 Moore et al ..2/24 X Primary Examiner-James R. BolerAttorney-Burd, Braddock 8L Bartz [57] ABSTRACT A garment for protectingan elbow or other protuberance of a bedridden patient includes sleevefor encompassing such protuberance. The sleeve is made from a clothhaving a rela' tively low coefficient of friction with respect to sheetsand other bedclothes and employing a nonabsorbent monofilament fibersuch as nylon. The sleeve has a stretchability at least in directiontransverse of the axis of the sleeve, A nonslip cushion constituted as asheet of foam rubber is adhered to the interior of the sleeve to providea protuberance-covering pressure-bearing portion constituted as alaminate of foam rubber sheeting directly in contact with the flesh andcovered by the cloth layer, this portion being devoid of any seams orother obstructions which can cause localized pressure on the flesh atthe pressure-bearing portions of the protuberance. A casing in the endof each sleeve completely covers an elastic cord. Together they tend toprevent the sleeve from rolling up and they act to stabilize the garmentto maintain the cushion in contact with the pressure bearing portion ofthe flesh adjacent the protected protuberance.

8 Claims, 6 Drawing Figures PROTECTIVE GARMENT FOR BEDRIDDEN PEOPLEBACKGROUND OF THE INVENTION A continuing problem in the care ofbedridden patients involves the pain and discomfort and the breakdown oftissue which develops in the pressure-bearing portions of fleshsurrounding the various protuberances of the body. Specifically, theflesh around the bony protuberances of the elbows, knees, and the heelsare subject to this kind of damage. Causes include breakdown of tissuedue to constriction of capillary flow within the flesh, the pinching andabrading of nerves in the same area, and the abrasion initially on theskin and, as this wears away, on subcutaneous layers due to movementover the sheets and other bedclothes.

For many years it has been known that some relief can be obtained forthe heels and the toes of the foot by providing a footboard along thebottom of the bed and draping the bedclothes over that footboard thus tokeep the weight of the bedclothes off of the feet, minimizing the directpressure on the toes, for example, while limiting the pressure whichmust be carried by the heel to the weight of the foot.

Various garments and wrappings have been suggested for furtheralleviating this problem, but each has been subject to one or moreobjections. Specifically, U.S. Pat. No. 3,322,118 to Sotherlin disclosesa device for projecting the elbow or heel of a bedridden patient, butdiscloses elastic cuffs of substantial longitudinal dimension which aresupposed to be for the purpose of preventing the device from moving outof proper alignment with the part to be protected. In order to getsufficient nonslip action, these cuffs have a substantial width and arefairly tight on the arm. This wide band of pressure causes manycapillaries to be cut 05. Thus the flesh underneath these cuffs has beenfound to be subject to the same kind of discomfort and pain, if notdamage, which the device is intended to alleviate. Furthermore, thesecuffs have been found to roll up along the edge, thus causing even moreconstriction to the circulation clear around the limb, and thus morepain and discomfort.

The prior art shows cushions positioned in cloth envelopes; but thisplacement of cloth between the cushion and the arm prevents the cushionfrom clinging to the flesh to deter relative movement of the cushion andflesh. Thus the device of Sotherlin is subject to the objection thatthis slides easily from its intended position and off of theprotuberance which is designed to protect.

Other devices in which a seam is situated in line with the area of theprotuberance subject to the damage are objectionable because thelocalized pressure of such seams induces the discomfort and pain andultimately the damage the garment is designed to eliminate.

SUMMARY OF THE INVENTION Protective garments of the present inventionhave been designed to overcome the difiiculties in the prior art and toinhibit or completely prevent tissue breakdown due to prolongedinterruption of circulation through the capillaries in thepressure-bearing flesh between the protuberance and the bed on which thepatient is resting.

In a protective garment made according to the present invention asshown, a cloth sleeve made from monofilament, hard-surface nonabsorbentfiber is provided with a protuberance-covering, presure-bearing areawhich is completely devoid of seams or other obstructions, and this areais covered with a cushioning sheeting of expanded foam material or thelike which, over the same area, is also devoid of seams, folds or otherobstructions. The expanded foam material is adhered to the clothmaterial on the inside of the sleeve so that the foam cushion comes indirect contact with the flesh over the protuberance to be protected. Thecushion has a high coefficient of friction with respect to this fleshand thus will lie in nonskid" relationship to such flesh, to tend toprevent relative movement there between.

The cloth sleeve is provided with a continuous casing around each ofouter end portions thereof, and an elastic cord is situated inside ofeach such casing, the casing and cord being of dimension to make asingle line contact with the limb at positions on either side of theprotected protuberance and to be held smoothly and snugly against theflesh of the patient at such positions. Because of the nonskidrelationship between the foam cushion and the flesh over theprotuberance, the tendency of the garment to slide with respect to theprotuberances is substantially lessened, but as the joint is flexed, theline contact between the casing and elastic cord and the flesh will tendto move, from time to time, thus permitting circulation throughcapillaries immediately adjacent the cord, to the end that the flesh'does not tend to break down as is the case when a wide band of elasticblocking circulation in many capillaries was employed. Use of nylon orsimilar cloth which tends to cling to the limb also help keep thegarment in position.

The cloth of the garment is stretchable in direction transverse of thelongitudinal axis of the sleeve so that flexure of the joint which isrelated to the protuberance will not in and of itself put pressure ofthe garment on the flesh.

By positioning the soft cushion in nonslip relationship over theprotuberance, and by providing a hard surface cloth on the outsidethereof, the friction between the protuberance and the bedclothes isreduced, and the friction-generating relative movement takes placebetween this cloth and the bedclothes rather than between the flesh overthe protuberance and the garment or bedclothes.

BRIEF DESCRIPTION OF THE DRAWING FIG. 1 is a side-elevational view ofthe foot of a bedridden patient resting with the heel on the bedclothesand showing a first form of the invention in position on said foot;

FIG. 2 is a perspective view of the protective garment of FIG. 1;

FIG. 3 is a bottom plan view of the protective garment of FIGS. 1 and 2;

FIG. 4 is an enlarged sectional view of the garment of the first threefigures taken as on the line 4-4 in FIG. 3;

FIG. 5 is a perspective view of a protective garment of the inventiondesigned to go on an elbow or knee; and

FIG. 6 is an enlarged sectional view of the garment of FIG. 5 taken ason the line 6-6 in that figure.

DESCRIPTION OF PREFERRED EMBODIMENTS As seen in the first four figures,a protective garment 9 for protecting the heel of a bedridden patientincludes a continuous hollow sleeve 10 made from a piece ofnonabsorbent, hard surface clot 11, made from a monofilament fiber suchas nylon. Longitudinal edges of this cloth have been sewn together atthe longitudinal seam 12 to form the sleeve I0, and darts l3 and 14 havebeen taken in top portions of the sleeve in order to shape it to betterfit over the foot and ankle on either side of the heel. Castings 15, 15are formed by turning under opposite end portions of the sleeve 10, andeach such casing encompasses an elastic cord 16 which will havesufficient resiliency to snugly hold the casing in place adjacent theheel as best seen in FIG. 1. It is to be noted that the contact on theflesh of the foot and ankle is virtually a line contact. It is to beunderstood that the force holding the casings 15, I5 and hence the endsof the sleeve in place is light enough so that there'will be someshifting of this line contact as the patient moves in bed, thusrestricting circulation permanently to no portion of the flesh.

of the heel on the bedclothes will always fall within that portion. itis to be noted that this portion is constituted as a laminate of thenylon cloth 11 and the foam rubber sheeting l7 and that this entire areais devoid of any seams or other obstructions which can cause localizedpressure on or around the flesh of the heel.

Referring now to FIGS. and 6, a protective garment 29 for protecting theelbow or knee of a bedridden patient will consist of a continuous hollowsleeve 30 made from a hard surface cloth 31. A longitudinal seam 32joining longitudinal edges of the cloth 31 makes the sleeve continuous,and a pair of casings 35, 35 each enclose an elastic cord 36. Foamrubber sheeting 37 is stitched as at 38 to the inside of the hollowsleeve 30 to form a protuberance-covering, pressure-bearing portion 39.

To put either of the garments in use, it will be slid over the end ofthe limb to be protected and the flesh between the bony protuberance ofthe heel, elbow or knee, will be situated in contact with the foamrubber cushion. The properties of this expanded foam sheeting materialare such that there is a high coefficient of friction between the fleshand the sheeting material, thus virtually assuring that the garment willnot become displaced and thereby assuring that the cushioning effect ofthis sheeting material on the flesh between the protuberance and thebedclothes will not be disturbed. This positioning is aided by thegentle but snug holding of the elastic cord and easing against portionsof the limb on either side of the protuberance, and by the clingingqualities of the nylon cloth, for example. Since there is only a line ofcontact at the casings, any capillary vessel which might possibly be cutoff by the pressure of the casing and its elastic cord will only be cutoff at one point, and the other capillaries will sufficiently nourishthe flesh in that general vicinity so that breakdown of the flesh willnot occur. Also, since this line of contact does tend to move as thepatient moves in bed and as the casing moves correspondingly over thelimb, the closed off capillary will be allowed to open, and blood willflow therein even though an adjacent capillary may then be closed offdue to the action of the casing and cord.

Although nylon cloth has been mentioned throughout the specification tothis point, it is to be understood that any cloth which will tend tocling to the limb and/or which has a hard, low friction surface can beemployed to make gan'nents of the invention. While, for the purposes ofshading, diagonal lines to represent woven cloth have been used, it isto be understood that the cloth will be sewed into the sleeve in such amanner that a substantial ability to stretch will be afforded thegarment in direction transverse of the longitudinal axis of the sleeveas seen in FIGS. 4 and 6, for example.

Because pain and discomfort afforded bedridden patients arises from theabrasion and/or pinching of nerves for an extended period on a localizedarea and from the destruction of tissues due to lack of circulation inlocalized areas, the provision for all of the friction of movement totake place between the cloth and the bedclothes (on the other side ofthe foam rubber sheeting from the flesh) and the provision that thereare no seams to cause localized pressure to be put through the foamrubber sheeting onto the flesh adjacent the protuberance effectivelyeliminates such pain, discomfort and/or breakdown of tissue.

While the foam rubber sheeting is illustrated and described as beingstitched to the cloth, it is to be understood that there are othereffective ways of adhering the sheeting to the cloth and that these willbe satisfactory as long as the pressure-bearing portion is maintaineddevoid of obstructions which can cause localized pressure to betransmitted through the garment to the flesh adjacent the protectedprotuberance.

The embodiment of the invention in which an exclusive property orprivilege is claimed are defined as follows:

1. A garment to protect the flesh adjacent a bony protuberance of a limbof a bedridden patient, said garment including a hollow sleeve offlexible, hard surface cloth having a relatively low coefficient offriction with respect to bed clothes, a

smooth resilient flesh contacting cushion sheet having a relatively highcoefficient of friction with respect to flesh, said sheet being adheredto an interior surface of a portion of said sleeve to provide alaminate, protuberance-covering, pressure-bearing garment portion devoidof obstruction, at least one casing at an end portion of said sleeve,and an elastic cord in said casing tensioning said casing to tend tohold said end portion snugly in contact with portions of the limb ofsuch patient adjacent said protuberance when said cushion is in contactwith the flesh adjacent the protuberance.

2. The combination of claim 1 wherein said casing and cord makesubstantially only a line of contact with the flesh around the limb.

3. The combination of claim 2 wherein the elastic causes such tensioningof the casing against the flesh that the casing will tend to be easilydisplaced due to movement of the patient in bed, and wherein the cushionwill have a sufficiently high coefficient of friction with respect tothe flesh to tend to strongly resist movement with respect thereto dueto movement of the patient in bed.

4. The combination of claim 1 wherein the cloth sleeve is furthercharacterized as having a tendency to cling to a limb around which saidsleeve is positioned.

5. The combination of claim 4 wherein said cushion is made of anexpanded foam material.

6. The combination of claim 5 wherein said cloth is made from amonofilament nylon fiber.

7. The combination of claim 2 wherein the casing completely encompassesthe cord and wherein the cord is formed as a continuous loop inside thecasing.

8. The combination of claim 1 wherein the cloth of said sleeve is madeup of nonabsorbent material.

1. A garment to protect the flesh adjacent a bony protuberance of a limbof a bedridden patient, said garment including a hollow sleeve offlexible, hard surface cloth having a relatively low coefficient offriction with respect to bed clothes, a smooth resilient, fleshcontacting cushion sheet having a relatively high coefficient offriction with respect to flesh, said sheet being adhered to an interiorsurface of a portion of said sleeve to provide a laminate,protuberance-covering, pressure-bearing garment portion devoid ofobstruction, at least one casing at an end portion of said sleeve, andan elastic cord in said casing tensioning said casing to tend to holdsaid end portion snugly in contact with portions of the limb of suchpatient adjacent said protuberance when said cushion is in contact withthe flesh adjacent the protuberance.
 2. The combination of claim 1wherein said casing and cord make substantially only a line of contactwith the flesh around the limb.
 3. The combination of claim 2 whereinthe elastic causes such tensioning of the casing against the flesh thatthe casing will tend to be easily displaced due to movement of thepatient in bed, and wherein the cushion will have a sufficiently highcoefficient of friction with respect to the flesh to tend to stronglyresist movement with respect thereto due to movement of the patient inbed.
 4. The combination of claim 1 wherein the cloth sleeve is furthercharacterized as having a tendency to cling to a limb around which saidsleeve is positioned.
 5. The combination of claim 4 wherein said cushionis made of an expanded foam material.
 6. The combination of claim 5wherein said cloth is made from a monofilament nylon fiber.
 7. Thecombination of claim 2 wherein the casing completely encompasses thecord and wherein the cord is formed as a continuous loop inside thecasing.
 8. The combination of claim 1 wherein the cloth of said sleeveis made up of nonabsorbent material.